Volume 203 Issue 4

A low-cost service that could prevent vision loss

Yogesan Kanagasingam

Trailblazing former MJA editor diesProfessor Priscilla Kincaid-Smith, former acting editor of the Medical Journal of Australia, and a trailblazer for Australian female scientists, has died at her Melbourne home from complications following a stroke, the ABC reports. She was 88. Professor Kincaid-Smith was a world-renowned nephrologist, discovering the link between overuse of headache powders and kidney disease. She was the first female professor at the University of Melbourne in 1975, first female chair of the Royal Australian College of Physicians, first female chair of the Australian Medical Association and the first female — and first Australian — chair of the World Medical Association. She was acting editor of the MJA in 1995. A full obituary will be published in a forthcoming issue of the MJA. Social media use linked to teens’ mental healthA new Canadian study has found that teenagers who use social media sites for two hours or more each day are significantly more likely to suffer from poor mental health, psychological distress and suicidal thoughts, the Huffington Post reports. “It could be that teens with mental health problems are seeking out interactions as they are feeling isolated and alone,” Dr Hugues Sampasa-Kanyinga, the lead author of the Ottawa Public Health study, wrote. “Or they would like to satisfy unmet needs for face-to-face mental health support.” The solution, he suggested, was not to get teens off social media. “Since teens are on the sites, it is the perfect place for public health and service providers to reach out and connect with this vulnerable population and provide health promotion systems and supports.” Nominations open for 2015 ACHS MedalNominations for the Australian Council on Healthcare Standards 2015 ACHS Medal are now open. The award recognises outstanding achievement in the advancement of quality and safety in health care in Australia. “The ACHS Medal provides an opportunity to further promote the work of an individual who has made a strong contribution in their particular field in health, by highlighting the improvements being made in safety and quality,” ACHS Chief Executive Officer, Dr Christine Dennis, said. Recent recipients of the medal include Kae Martin (2014); Adjunct Professor Christopher Brook PSM (2013); and Professor Robert “Bob” Gibberd (2012). The closing date for nominations is 5pm, Friday 25 September, and the nomination form can be found at www.achs.org.au/ACHSMedal Top Canadian pathologist steps downRetraction Watch reports that prominent pathologist Dr Sylvia Asa has resigned from running the largest hospital diagnostic laboratory in Canada because of an investigation that uncovered evidence of falsified data in two papers. Dr Asa was the program medical director of the Laboratory Medicine Program at the University Health Network, affiliated with the University of Toronto. Two papers coauthored by Dr Asa have been retracted by the American Journal of Pathology. “Following correspondence in September 2012 from a concerned reader … [an investigative committee] informed the Editors in April 2015 that the articles in question contain falsified data”, the AJP editors said. Problems included “manipulated and/or fabricated data”. Transgender women show “shocking” HIV ratesA World Health Organisation report shows that a transgender woman was 49 times more likely to be living with HIV [than the general population] in 15 countries in which data was analysed, NPR reports. Transgender people are not receiving adequate health care, and widespread discrimination is largely to blame, according to the WHO paper. Among sex workers, transgender women are nine times more likely to have HIV than their non-transgender counterparts. “What is driving the epidemic is really the refusal of governments to pass legislation that allows [transgendered people] to function in society, and allows them to participate in the workplace”, JoAnne Keatley, a coauthor of the WHO report, said. “Trans people struggle in order to obtain identity documents that allow them to participate in the workforce. Many trans people are not able to obtain health coverage.”

Cate Swannell

More enlightened teaching would go a long way towards solving problems of discrimination in medicine

Merrilyn M Walton BA, MSW, PhD

Sexual abuse in the medical profession is a complex, multifaceted problem that needs evidence-based solutions

Louise E Stone MPH, MQHR, PhD · Kirsty Douglas DipRACOG, MD, FRACGP · Imogen Mitchell PhD, FRACP, FCICM · Beverley Raphael AM, MD, FRANZCP

Responsibility for health care in detention must be transferred from the Department of Immigration and Border Protection to an independent body

Peter Young MB BS, FRANZCP

Continued vigilance and screening of high-risk men and women for is advised

Pam Konecny MD, FRACP, FAChSHM · Josephine Lusk MB ChB, PhD, FAChSHM

Increased testing could be partly due to previous guideline recommendations

Veronica C Hoad MB BS, MPH, FAFPHM · Aesen Thambiran MB BS, FRACGP

The RACGP recommend that screening be limited to those at highest risk

Katy Bell MB ChB, MMed(ClinEpi), PhD

The RACP urges a rights-based and humane approach to people seeking asylum

Georgia A Paxton MB BS(Hons), MPH, FRACP · Sarah Cherian MB BS(Hons), FRACP, PhD · Karen J Zwi MB BCh, FRACP, MRCP(UK)

Policy interventions should support clinician-led efforts regarding consensus on low-value care and how to reduce it

Ian A Scott FRACP, MHA, MEd · Stephen J Duckett DSc, FASSA, FAHMS

Current strategies are not doing enough

Stephen J Duckett DSc, FASSA, FAHMS · Peter Breadon MPA, MPP, BA · Danielle Romanes BA(Hons)

Tracking publication output from intervention research is important for accountability

Lesley A King BSc, MPsychol · Robyn S Newson BPhysiother, MPH · Gillian E Cohen BAppSci, MPH · Jacqueline Schroeder BSc, MA · Selina Redman AO, PhD · Lucie Rychetnik PhD, MPH · Andrew J Milat PhD, MPH(Hons), BHMS(Ed)(Hons) · Adrian Bauman PhD, FFAPHM · Simon Chapman PhD, FASSA, HonFFPH

Practices associated with humiliating medical students persist in contemporary medical education, more commonly in subtle than overt forms

Karen M Scott PhD, MA, BEd · Patrina HY Caldwell BMed, FRACP, PhD · Elizabeth H Barnes MStat, BAppSc · Jenny Barrett DEd, MEd, BA

Differentiating fascioliasis from other parasitic conditions is important, as the recommended management is specific

Mel Figtree FRACP, FRCPA, MPH&TM · Miles H Beaman FRACP, FRCPA, FACTM · Rogan Lee BVSc, MSc, PhD · Michelle Porter DTM&H, FRACP, FRCPA · Eric Torey MB BS, FRACS · Thomas J Hugh MD, FRACS · Bernard J Hudson MB BS, FRACP, FRCPA

Sexual harassment in medicine has implications for employers, professional colleges and associations, and regulators

Ben Mathews PhD, LLB, BA · Marie M Bismark MB ChB, LLB, MPH

Is it ever ethically appropriate for health care workers to decline to care for patients with Ebola, and how should treatment decisions be made?

Thomas Solano MB BS, FRACP, FCICM · Gwendolyn L Gilbert MB BS, FRACP, FRCPA · Ian H Kerridge BA, FRACP, FRCPA · Vineet Nayyar MB BS, FRACP, FCICM · Angela Berry BAppSc(Nurs), MAppSc, PhD

Medical colleges should take the lead in abolishing discrimination, bullying and sexual harassment

David AK Watters ChM, FRCSEd, FRACS · David J Hillis MHA, FRACMA, FRACS(Hon)

the RACS will need to act on its expert panel's recommendations and not shrink from difficult decisions

Michael J Hollands MB BS, FRACS

Advances in media technology have had a significant impact on our daily lives, in terms of how we conduct business and leisure. Recent events have also had significant emotional impact and we wish to highlight the potential health impact. The grief experienced following the death of a loved one can be one of the greatest stressors for those surviving — spouse and/or relatives. It is not only the emotional strain but also physiological changes in the immediate period after bereavement1,2 that affect health. Bereavement may also affect non-relatives, which was only captured by these two patients referred independently for ambulatory blood pressure (ABP) monitoring as part of their clinical management. Both watched the televised broadcast of funeral proceedings for Australian cricketer Phillip Hughes. Although neither was a relative of Phillip Hughes and neither had met him, they both reported an emotional response to the broadcast. Panel A in the Box shows the ABP recording for a woman who was taking an angiotensin II receptor antagonist. The recording shows that she had an increase in systolic blood pressure (25 mmHg) while she was sitting watching the funeral that was comparable with her responses to physical activity. The ABP recording for the second woman is shown in Panel B in the Box; her antihypertensive therapy included β-blockade. There was a 25 mmHg increase in systolic blood pressure while she sat watching the broadcast of the funeral. The increase was comparable with that for people with mild hypertension receiving mental stressor tests3 and may have been greater in the absence of β-blockade. Such increases in blood pressure reflect overall changes in the cardiovascular system at the time of emotional stress and are associated with heightened cardiovascular risk.4,5 We therefore need to be aware of the significant impact that media technology may have on our health and consider preventive treatment strategies. 1 Ambulatory blood pressure recordings for two patients who watched a televised funeral* *Neither patient was related to the deceased.

Anastasia S Mihailidou BSc, PhD · Thomas Buckley BSc(Hons), MN, PhD · Alexandra JC Bune MB BS, FRACP, DSc(Hon) · Geoffrey Tofler MB BS, MB, FRACP

An Australian doctor reflects on a difficult but satisfying 6-week placement at an Ebola Treatment Centre in Freetown, Sierra Leone

Rosalie Schultz FAFPHM, FRACGP, FARGP

How can we help our patients make sensible decisions?

Ian E Haines MB BS, FRACP, FAChPM

There is sickness in the family …

Michele Seminara

Female orthopaedic surgeons are a small minority, but Dr Susan Liew has climbed to the top of the profession through hard work, passion and an undying fascination with how things work and how to put broken things back together

Cate Swannell

Almost 400 delegates gathered in Hobart late last month for the 2015 National Suicide Prevention Conference, organised by Suicide Prevention Australia.

Cate Swannell

Professor Emma McBryde, one of Australia's leading infectious disease experts has joined James Cook University

Cate Swannell